Fifth disease and pregnancy

Fifth disease is a common childhood illness that’s usually pretty mild. But if you get infected during pregnancy, it may hurt your baby.

What causes fifth disease?
Fifth disease is caused by a virus called parvovirus B19. It’s called fifth disease because many years ago, it appeared fifth in a list of common causes of childhood rash and fever. It usually spreads through the air from an infected person's cough or sneeze.

What problems does fifth disease cause in pregnancy?
Most unborn babies are not harmed if their mother gets fifth disease. But some babies do become infected. The virus can make it hard for babies to make red blood cells, which can lead to:

  • A dangerous form of anemia. Anemia is when you don’t have enough healthy red blood cells to carry oxygen to the rest of your body.
  • Heart failure
  • Miscarriage, when a baby dies in the womb before 20 weeks of pregnancy
  • Stillbirth, when a baby dies in the womb before birth, but after 20 weeks of pregnancy

What are the symptoms of fifth disease?
Symptoms in children include:

  • A rash on the face that looks like a slapped cheek. Rash also can appear on a child’s arms, legs and torso (trunk of the body). Rash is the most common sign in children.
  • Fever
  • Headache
  • Sore throat
  • Joint pain

Infected adults often have pain and swelling in their joints and sometimes mild flu-like symptoms. Adults usually don’t get a rash. Symptoms in both children and adults generally appear between 4 and 21 days after infection.

If you think you’ve come in contact with fifth disease or have symptoms that may be caused by it, tell your health care provider immediately. If you have a rash, your health care provider may be able to diagnose fifth disease during a physical exam. If you don’t have a rash, blood tests can help determine if you have fifth disease.

Who is at risk of getting fifth disease?
People with young children and who work with children (such as child care providers and teachers) are most likely to come in contact with fifth disease and get infected.

How can you avoid fifth disease during pregnancy?
Here are some ways to protect yourself from getting infected:

  • Wash your hands well after being around children.
  • Carefully throw away tissues used by children.
  • Don’t share drinking glasses, cups, forks or other utensils with anyone who has fifth disease or who is in contact with someone who has fifth disease.

How is fifth disease treated?
There is no treatment. Fifth disease usually is mild and goes away on its own.

If you’re pregnant and become infected, your health care provider monitors your pregnancy carefully for problems with your baby. He may recommend that you have an ultrasound once a week or every other week for 8 to 12 weeks. If ultrasound doesn’t show any problems, you don’t need any more testing.

If an ultrasound shows that your baby is having problems, your provider may recommend amniocentesis to confirm the infection. If your baby has fifth disease, chances are the infection will go away on its own. Your provider may monitor your baby’s health during routine prenatal care visits.

Fifth disease causes severe anemia in the babies of fewer than 5 percent of infected pregnant women. Severe anemia can cause hydrops, a buildup of fluid in your baby’s body. Hydrops can lead to a baby’s heart failure and death. If an ultrasound shows that your baby has hydrops, your provider may use a special procedure called cordocentesis to check the severity of your baby’s anemia. During this test, your provider inserts a thin needle into an umbilical cord vein to take a small sample of your baby’s blood for testing.

If your baby has severe anemia, your provider may be able to treat it by giving her a blood transfusion through the umbilical cord. Blood transfusion is having new blood put into your body. In most cases, the anemia isn’t severe and your provider may simply monitor your baby for any new health problems before birth.

If your baby has hydrops from fifth disease during the third trimester, you may need to be induced to give birth early. Your provider can talk to you about birth and treatment options for your baby.

How common is fifth disease?
About 6 in 10 adults (60 percent) had the infection as children. If you already had fifth disease, you can’t get it again.

About 1 in 400 women in the United States gets infected with fifth disease during pregnancy.

Last reviewed March 2012

Most common questions

What is mononucleosis?

Mononucleosis (also called mono) is an infection usually caused by the Epstein-Barr virus (EBV). It’s sometimes caused by another virus called cytomegalovirus (CMV). EBV and CMV are part of the herpes virus family. Mono is most common in teenagers and young adults, but anyone can get it. Mono is called the “kissing disease” because it’s usually passed from one person to another through saliva. In addition to kissing, it can also be passed through sneezing, coughing or sharing pillows, drinks, straws, and toothbrushes.

You can have mono without having any symptoms. But even if you don’t get sick, you can still pass it to others. Symptoms can include:

  • Achy muscles
  • Belly pain
  • Fatigue (feeling tired all the time)
  • Fever
  • Sore throat
  • Swollen glands in your neck

If your symptoms don’t go away or get worse, tell your health care provider. He’ll most likely do a physical exam and test your blood to find out for sure if you have mono.

There’s no vaccine to prevent mono. There’s also no specific treatment. The best care is to take it easy and get as much rest as you can. It may take a few weeks before you fully recover.

Can Rh factor affect my baby?

The Rh factor may be a problem if mom is Rh-negative but dad is Rh-positive. If dad is Rh-negative, there is no risk.

If your baby gets her Rh-positive factor from dad, your body may believe that your baby's red blood cells are foreign elements attacking you. Your body may make antibodies to fight them. This is called sensitization.

If you're Rh-negative, you can get shots of Rh immune globulin (RhIg) to stop your body from attacking your baby. It's best to get these shots at 28 weeks of pregnancy and again within 72 hours of giving birth if a blood test shows that your baby is Rh-positive. You won't need anymore shots after giving birth if your baby is Rh-negative. You should also get a shot after certain pregnancy exams like an amniocentesis, a chorionic villus sampling or an external cephalic version (when your provider tries to turn a breech-position baby head down before labor). You'll also want to get the shot if you have a miscarriage, an ectopic pregnancy or suffer abdominal trauma.

I had a miscarriage. How long should I wait to try again?

Before getting pregnant again, it's important that you are ready both physically and emotionally. If you don't need tests or treatments to discover the cause of the miscarriage, it's usually OK for you to become pregnant after one normal menstrual cycle. However, it may take longer for you to feel emotionally ready to be pregnant again. Everyone responds differently to a miscarriage. Only you will know when you are ready to try to get pregnant again.

Are gallstones common during pregnancy?

Not common, but they do happen. Elevated hormones during pregnancy can cause the gallbladder to function more slowly, less efficiently. The gallbladder stores and releases bile, a substance produced in the liver. Bile helps digest fat. When bile sits in the gallbladder for too long, hard, solid nuggets called gallstones can form. The stones can block the flow of bile, causing indigestion and sometimes serious pain. Staying at a healthy weight during pregnancy can help lower your risk of gallstones. Exercise and eating foods that are low in fat and high in fiber, like veggies, fruits and whole grains, can help, too. Symptoms of gallstones include nausea, vomiting and intense, continuous abdominal pain. Treatment during pregnancy may include surgery to remove the gallbladder. Gallstones in the third trimester can be managed with a strict meal plan and pain medication, followed by surgery several weeks after delivery.

©2013 March of Dimes Foundation. The March of Dimes is a non-profit organization recognized as tax-exempt under Internal Revenue Code section 501(c)(3).